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Ironwood Pharmaceuticals Inc.: Q4 FY2025 earnings call

What management said about Q4 FY2025, from the documents filed with the SEC on 25 February 2026: press release. Guidance figures: 3 kept. The quarter’s numbers.

Key takeaways

  • Full-year revenue fell, net income rose: Full-year 2025 total revenue was $296.2 million, down from $351.4 million. GAAP net income was $24.0 million, or $0.15 per share diluted, against $0.9 million in 2024. Source
  • Fourth quarter revenue fell sharply: Fourth quarter total revenue was $47.7 million against $90.5 million a year earlier. The quarter reported a GAAP net loss of $2.3 million, or $(0.01) per share. Source
  • Full-year prescription demand grew 11%: Total LINZESS prescription demand for 2025 was 234 million capsules per IQVIA, up 11%. The company cited this as the basis for its EUTRx demand growth figure. Source
  • Commercial margin fell in fourth quarter: LINZESS commercial margin was 54% in the fourth quarter, down from 64% a year earlier. Margin was 66% for both full years 2025 and 2024. Source
  • Fourth quarter net sales fell on rebates and pricing: U.S. LINZESS net sales were $163.2 million in the fourth quarter, down 27%. The company attributed the decline to rebate reserve phasing and Medicare Part D redesign pricing headwinds. Source
  • Year-end cash rose to $215 million: Cash and cash equivalents were $215.5 million at December 31, 2025, against $88.6 million a year earlier. Source
  • Apraglutide Phase 3 design finalized: Key elements of the confirmatory Phase 3 design for apraglutide in SBS-IF are finalized, following a fourth quarter 2025 FDA meeting. Site initiations are expected to begin in the second quarter of 2026. Source

“In 2025, LINZESS delivered 11% EUTRx demand growth year-over-year, continuing to strengthen its position as the prescription market leader for the treatment of IBS-C and CIC”

Tom McCourt, chief executive officer of Ironwood

Guidance

AreaPeriodFigureAgainst last quarter
U.S. LINZESS net sales Sourcefull year 2026$1.125 - $1.175 billionKept
Total revenue Sourcefull year 2026$450 - $475 millionKept
Adjusted EBITDA Sourcefull year 2026>$300 millionKept
Apraglutide confirmatory trial site initiations Sourcesecond quarter 2026site initiations expected to begin in the second quarter of 2026

What changed from last quarter

  • New: Ironwood, VectivBio and Ferring entered a license amendment and settlement agreement in December 2025, settling claims from Ferring's complaint. Ironwood agreed to pay $12.5 million. Source
  • New: The LINZESS list price was lowered effective January 1, 2026, in response to evolving health care dynamics and to support patient access.
  • New: The STARS-2 confirmatory trial is described as a 24-week, global, randomized, double-blind, placebo-controlled study, with design elements finalized after the fourth quarter FDA meeting. Source

Results and growth drivers

  • Full-year revenue fell, net income rose: Full-year 2025 total revenue was $296.2 million, down from $351.4 million. GAAP net income was $24.0 million, or $0.15 per share diluted, against $0.9 million in 2024. Source
  • Fourth quarter revenue fell sharply: Fourth quarter total revenue was $47.7 million against $90.5 million a year earlier. The quarter reported a GAAP net loss of $2.3 million, or $(0.01) per share. Source
  • Adjusted EBITDA up for year, down for quarter: Adjusted EBITDA was $138.1 million for full year 2025 against $129.4 million, and $10.9 million in the fourth quarter against $37.3 million. Prior-year figures were restated to the updated definition that excludes stock-based compensation. Source

Segments: U.S. LINZESS collaboration

  • Quarterly collaboration revenue fell 49%: Fourth quarter collaboration revenue from U.S. LINZESS sales was $45.2 million, compared with $88.4 million. The prior-year figure included a $7.2 million positive gross-to-net reserve adjustment. Source
  • Full-year collaboration revenue down 15%: Full-year 2025 collaboration revenue from U.S. LINZESS was $289.3 million, against $340.4 million in 2024. Other royalties and revenue were $6.9 million, against $11.0 million. Source
  • U.S. brand net profit declined: Net profit for the U.S. brand collaboration, after commercial and R&D expenses, was $81.5 million in the fourth quarter, down 40%. The full-year figure was $545.4 million, down 4%. Source

“With an improved financial position, we now have a clear path to execute our strategy, and we continue to evaluate all options to maximize shareholder value.”

Tom McCourt, chief executive officer of Ironwood

Products and prescription demand

  • Full-year prescription demand grew 11%: Total LINZESS prescription demand for 2025 was 234 million capsules per IQVIA, up 11%. The company cited this as the basis for its EUTRx demand growth figure. Source
  • Fourth quarter demand rose 13%: Fourth quarter LINZESS prescription demand was 63 million capsules, a 13% rise per IQVIA, while fourth quarter U.S. net sales fell 27%. Source
  • Pediatric IBS-C label expanded in November: The FDA approved LINZESS for IBS-C in patients aged 7 and older. The company said this makes LINZESS the first and only prescription drug approved for IBS-C in patients 7 to 17 years old. Source

Costs and expenses

  • Full-year costs fell from 2024: Full-year 2025 total costs and expenses were $197.6 million, against $258.3 million. Selling, general and administrative expense was $82.3 million and R&D expense was $95.1 million. Source
  • Ferring settlement charged to SG&A: The Ferring settlement added a $12.5 million charge to SG&A in 2025, of which $5.0 million was recorded in the fourth quarter. The company paid $7.5 million in December 2025. Source
  • Fourth quarter restructuring was a reversal: Fourth quarter restructuring was a reversal of $0.3 million, against a $0.1 million charge a year earlier. Full-year 2025 restructuring expense was $20.3 million. Source

“Importantly, we ended 2025 with $215 million in cash and cash equivalents, positioning Ironwood well for 2026.”

Tom McCourt, chief executive officer of Ironwood

Margins and pricing

  • Commercial margin fell in fourth quarter: LINZESS commercial margin was 54% in the fourth quarter, down from 64% a year earlier. Margin was 66% for both full years 2025 and 2024. Source
  • Fourth quarter net sales fell on rebates and pricing: U.S. LINZESS net sales were $163.2 million in the fourth quarter, down 27%. The company attributed the decline to rebate reserve phasing and Medicare Part D redesign pricing headwinds. Source
  • 2026 net sales expected to rise on list price: Management said the lower LINZESS list price, effective January 1, 2026, is expected to raise 2026 net sales by removing the inflationary rebate component.

Cash, debt and capital

  • Year-end cash rose to $215 million: Cash and cash equivalents were $215.5 million at December 31, 2025, against $88.6 million a year earlier. Source
  • Fourth quarter operating cash flow rose: Cash from operations was $74.6 million in the fourth quarter, against $15.2 million a year earlier. Full-year 2025 cash from operations was $127.0 million, against $103.5 million. Source
  • Revolver balance unchanged at $385 million: The revolving credit facility principal was $385.0 million at year-end, the same as the prior year-end balance. Full-year 2025 interest expense was $32.7 million. Source
  • Convertible notes now classified as current: Convertible senior notes of $199.7 million were classified as a current liability at year-end, while the prior year-end balance had no current portion. Source

Strategy and apraglutide development

  • Apraglutide Phase 3 design finalized: Key elements of the confirmatory Phase 3 design for apraglutide in SBS-IF are finalized, following a fourth quarter 2025 FDA meeting. Site initiations are expected to begin in the second quarter of 2026. Source
  • STARS-2 primary endpoint defined: The STARS-2 primary endpoint measures relative change from baseline in actual weekly parenteral support, with additional key secondary endpoints. Source
  • Strategic alternatives review continues: The company had previously announced a strategic alternatives review. In the fourth quarter release management said it continues to evaluate all options to maximize shareholder value.

Coming up, as management said on 25 February 2026

  • STARS-2 sites open in second quarter: Management said it looks forward to initiating sites for the STARS-2 trial in the second quarter of 2026. Source
  • Debt reduction planned from 2026 earnings: Management expects 2026 adjusted EBITDA to enable continued apraglutide work and a reduction in debt. Source
  • Ferring final payment due end-2026: Ironwood owes the remaining $5.0 million to Ferring by December 31, 2026, with earlier payment possible in certain circumstances. Source

Figures management reported

FigureReported
LINZESS U.S. net sales, full year 2025 Source$864.5 million, down 6%
LINZESS prescription demand, fourth quarter 2025 Source63 million capsules, up 13%
LINZESS commercial margin, full year 2025 Source66%
R&D expenses, fourth quarter 2025 Source$21.9 million
Pipeline milestone, apraglutide STARS-2 SourceSite initiations expected to begin in Q2 2026
Approval, LINZESS IBS-C label expansion SourceApproved November 2025, patients aged 7 and older

Risks management discussed

  • Regulatory: Medicare Part D redesign pricing headwinds and rebate reserve phasing reduced fourth quarter U.S. LINZESS net sales. Source
  • Financial: Management cited the need to maintain compliance with debt covenants over the coming quarters.

Earlier plans management reported on

  • On track: In January, management said it was on track to initiate the confirmatory trial in the first half of 2026.
  • Met: In January, management said it was on track for the low end of 2025 LINZESS and total revenue ranges. This release headlines achievement of 2025 financial guidance. Source

Other quarters

Summarised with AI from the documents the company filed with the SEC. Every point is checked against the filing before it is shown: management’s own words word for word, figures against the line or table row they come from. A point that fails the check is left out. Source opens the filing at that line.